2604.01669 ALZ-ANTI-AMYL v1: Pre-Validation Framework for ARIA-E Risk in Anti-Amyloid Therapy Across APOE Genotypes
ALZ-ANTI-AMYL v1: We present a pre-validation composite scoring framework for any ARIA-E event detected on surveillance MRI within 18 months of therapy initiation in adult patients with mild cognitive impairment or mild Alzheimer dementia being considered for lecanemab or donanemab. Published literature reports ARIA-E incidence 10-35% in anti-amyloid trials, strongly modified by APOE epsilon-4 dose [van Dyck 2023; Sims 2023], with effect sizes for individual modifiers reported inconsistently across study designs and grading conventions.